Legal Issues

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Some people fear being sued as a result of performing first aid in an emergency. Understanding more about the legalities can help reduce this fear. All states have passed what are known as “Good Samaritan laws,”to help encourage bystanders to assist those in need.

These laws help protect anyone who:• Voluntarily provides assistance, without expecting or accepting compensation,• Is reasonable and prudent,• Does not provide care beyond the training received, and• Is not “grossly negligent,” or completely careless, in delivering emergency care.

Good Samaritan laws vary slightly from state to state. Become familiar with the laws in your state and other states where you work or travel.

Everyone has the right to refuse medical treatment. It is appropriate to ask a responsive person if they want help before providing care. When a person is or becomes unresponsive, the legal concept of “implied consent” allows a provider to help without asking, because it assumes the person would agree to be helped if responsive.

If a parent or guardian is present with an ill or injured child, obtain the parent or guardian's consent prior to giving care. When one is not present, the consent to provide care to a child is legally implied. Provide care and contact a parent or guardian as soon as reasonably possible.

Once care has begun, and it is safe to do so, remain with an ill or injured person until someone with equal or greater emergency medical training takes over. If alone,it is okay to leave to activate EMS, but return to the person as soon as you can.

There has never been a successful lawsuit in the United States against a person providing first aid in good faith.

Still, it is appropriate to use common sense:

• Activate EMS immediately.• If the scene is unsafe, do not enter!

• Ask a responsive person for permission before giving care.

• Never attempt skills that exceed your training.

• And, once you have started, don’t stop until someone with equal or greater training relieves you.

Other Legal Considerations:

Duty to Act — A predetermined requirement to provide care, typically by job description (such as firefighter, police officer or lifeguard) or by relationship (such as parent or guardian). In general, a first aid trained person is encouraged, but not required by duty, to act.

Negligence — Occurs when someone is caused further harm due to care that did not meet the expected standard of someone with a duty to act.

Assault & Battery — Placing a person in fear of bodily harm. Forcing care on a person against his wishes may be considered grounds for this.IntroductionMost students in your basic First Aid and CPR courses will not be healthcare providers and can be classified as lay providers. As lay providers they are not formally medically trained, do not work in the healthcare industry, do not provide direct patient care, and are not considered to have a ‘duty to act.’

Students in a professional rescuer course may have a duty to act. Professional responders, licensed healthcare providers or public safety first responders (e.g. paramedics/EMTs, nurses, doctors, police or correctional officers, lifeguards) have a duty to act. They have a legal obligation to respond to an emergency while on duty, according to statute or job description. If off duty, they would be responding voluntarily, and would generally be covered under the Good Samaritan Law.​Personnel such as security officers, construction foremen and teachers are usually required to have First Aid and CPR training as part of their job. They are considered lay providers in most cases. If they are designated workplace responders, however, they may have a duty to act, depending on statute and their job description.

​Moral & Ethical Responsibilities Even if a rescuer does not have a duty to act or a legal obligation to perform CPR (e.g. lay responder, off-duty professional rescuer), he or she should be aware of some moral and ethical responsibilities. It may help to clearly define the terms:

Moral: adj. concerned with right and wrong and the distinctions between them,virtuous, good, capable of a right or wrong action, serving to teach a right action. Ethical: adj. dealing with ethics, relating to morality of behavior, conforming with an accepted standard of good behavior. What those definitions mean to the students in your certification courses is that even if they are not legally bound to help, they possess the skills to help someone in need of First Aid or CPR. If it is safe to do so, the trained rescuer should assist those in need.

Students should be instructed that regardless of age, gender, race, ethnicity or socioeconomic status, they should accept the responsibility to render care to fellow human beings. Once beginning emergency care, a responder should not abandon the victim. They have a legal obligation to stay with the victim until help arrives. It is the rescuer’s responsibility to update their skills and reinforce their training with continuing education and re-certification courses. They should practice and review their skills on a regular basis. First aid is only as effective as the person performing it. Know the skills and practice them regularly.

Good Samaritan LawGood Samaritan Laws are put into place to encourage the rescuer to act. Every statehas a version of a Good Samaritan Law. It is vitally important that you, the instructor, are familiar with how the Good Samaritan Law is written in your state so that you are prepared to answer questions about the law. Keep a copy of your state’s Good Samaritan Law. If you need help finding your state’s Good Samaritan Law, there are many websites available that locate laws and codes by key words. You can also visit your local library or call EMS Safety Services for guidance in locating your state’s Good Samaritan Law. The Good Samaritan Law in most states is designed to protect rescuers from fear of being sued when they choose to act in an emergency. Although anyone can be sued, the Good Samaritan Law provides protection to rescuers as long as they adhere to the stipulations within the law.

Common elements of a Good Samaritan Law include, but are not limited to, the following:  Responding to help or an emergency situation on a voluntary basis. o The rescuer does not have a ‘duty to act.’ Not expecting compensation for rendering care. Providing care without gross negligence (carelessness, recklessness). o Harm did not come to the victim as a result of the rescuer’s reckless actions. Providing care with good faith (good intentions) and within the limits of your training.  Not abandoning the victim after beginning care. Stay with the victim until help arrives. In the instance of CPR, the patient is already clinically dead (cardiac arrest), so it is very difficult to cause harm to that person.Gaining Consent The rescuer must gain consent from the victim before beginning care. Everyone has the legal right to refuse care. To provide care against someone’s will can meet the legal definition of assault and battery; transporting someone to a hospital without his or her consent can meet the legal definitions of kidnapping and false imprisonment. When first approaching a victim, the rescuer should give his or her name, level of training, and intentions, then request permission to begin care.

For example, “My name is ____, I’ve been trained in first aid, and you appear to be bleeding badly. Can I help you?”

Types of Consent:Expressed: The victim is a competent adult, informed of procedures and risks. The victim has given consent for care. Implied: Consent is assumed from the victim who is unresponsive or confused. This is based on the assumption that the responsible person would consent to life saving care. This is most often the consent gained in CPR-related situations.Children/Minors: This also applies to mentally incompetent adults. Consent must be obtained from the parent or legal guardian. If the parent/legal guardian is not available for consent in a life-threatening situation, begin care (default to implied consent). The Right to Refuse Care Every mentally competent adult has the right to refuse care. It is not the place of the first aid responder to force care on or make a decision for the victim. Even after you begin care the person can, at any time, refuse further care. An example of this is the person who becomes responsive and refuses further treatment.Instruct students that they should not force care when it is refused. If they feel a person needs care, they should first ensure their own safety. Keep an eye on the situation from a distance, and contact the Emergency Medical Services (EMS) by calling 9-1-1 or your local emergency response number.

The Right to PrivacyPeople have a right to privacy. Information belongs to the person. Keep personal information private. Do not give the victim’s information out to bystanders or coworkers. It is acceptable to give information to advanced medical responders who take over care, and to the person in charge of workplace safety.Do Not Attempt Resuscitation Most states have state-wide out-of-hospital ‘Do Not Attempt Resuscitation’ (DNAR) protocols, authorized by statute, regulation, or guidelines. Research your state’s laws and protocols on DNAR in the out-of-hospital setting.

Learn about your state’s Advance Directives (e.g. living wills and medical power of attorney) from your physician or attorney. These decisions must be made and the advance directives or physician signatures must be discussed and put in place before an emergency occurs.

“Do Not Resuscitate” orders written for a patient in the hospital are usually specific to that setting. In most states a physician must write a specific ‘No CPR’ order for out-ofhospital cardiac arrest. In some states a person with a DNAR order will wear medical jewelry that says “No CPR.” In this situation, do not start CPR; call 9-1-1 and tell the dispatcher that the unresponsive person is wearing jewelry that states, “No CPR

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